Objective　To systematically evaluate the overall reliability， test paper structure and rationality proportional distribution of the secondary discipline of western medicine comprehensive test papers from 2010 to 2012 to provide references for future improvement to the syllabus and test quality. Methods　Data of 15 765 candidates from 2010 to 2012 were extracted and statistical analy-sis was performed to do generalized research and decision-making research from discipline factors and question type factors. Results　①Based on the discipline factor analysis， variance components of ba-sic disciplines were relatively high ， global score relative error was very small and the generalizability coefficient was above 0.930. ②Based on the question type factor analysis， variance components in X-type questions and A1-type questions were relatively high， global score relative error was very small and the generalizability coefficient was above 0.930. Conclusions　①From the discipline content， the accuracy of various disciplines is high； contribution of basic disciplines is relatively higher than that of clinical disciplines； further improving the discrimination of questions can help to improve measure-ment accuracy. ②From the question design， question measurement error is small， accuracy is high， and the question distribution is appropriate； scale of A3 type questions can be further improved.